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. 2012 May;32(5):409-16.
doi: 10.1002/pd.2897. Epub 2011 Oct 26.

Amniocentesis in twin pregnancies: a systematic review of the literature

Joy Vink  1 , Karin Fuchs, Mary E D'Alton
Affiliations

Amniocentesis in twin pregnancies: a systematic review of the literature

Joy Vink et al. Prenat Diagn. 2012 May.

Abstract

Objective: Using published data, we sought to determine the amniocentesis-related loss rate in twin gestations.

Methods: We searched the PUBMED database using keywords "amniocentesis", "twin" and "twins" to identify articles evaluating genetic amniocentesis in twin gestations published from January 1970 to December 2010. Random effects models were used to pool procedure-related loss rates from included studies.

Results: The definition of "loss" varied across the 17 studies identified (Table 1). The pooled procedure-related loss rate at < 24 weeks was 3.5% (95% confidence interval [CI] 2.6-4.7) (Figure 2). Pooled loss rates at < 28 weeks (Figure 4) and to term (Figure 5) could not be calculated due to unacceptable heterogeneity of available data. Seven studies included a control (no amniocentesis) group and reported a pooled odds ratio for total pregnancy loss among cases of 1.8 (95% CI 1.2-2.7) (Figure 3). Only 1 study reported procedure-related loss rates by chorionicity (7.7% among monochorionics vs 1.4% among controls; p 0.02).

Conclusion: Analysis of published data demonstrated a pooled amniocentesis-related loss rate of 3.5% in twin gestations < 24 weeks. Pooled loss rates within other post-amniocentesis intervals or other gestational age windows and the impact of chorionicity on procedure-related loss rates cannot be determined from published data.

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Figures

FIGURE 1
FIGURE 1
Literature search flow charts
FIGURE 2
FIGURE 2
Post-amniocentesis pregnancy loss < 24 weeks. I2=0%, p-value 0.3. Proportion meta-analysis plot (random effects). Pooled loss-rate = 3.5% (97% CI 2.6-4.7).
FIGURE 3
FIGURE 3
Total pregnancy loss in twins undergoing amniocentesis vs twins that did not undergo amniocentesis. Odds ratio = 1.8 (95% CI 1.2-2.7).
FIGURE 4
FIGURE 4
Post-amniocentesis pregnancy loss < 28 weeks. Heterogeneity I2=31%. Proportion meta-analysis plot (random effects).
FIGURE 5
FIGURE 5
Total post-amniocentesis pregnancy loss (to term). Heterogeneity I2=43%. Proportion meta-analysis plot (random effects).
See this image and copyright information in PMC

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